by Juliet Holt Klinger
01 November 2018

Many ethical dilemmas can arise for those providing care for people living with dementia. The very nature of dementia sometimes leads families into situations of decision-making that they have never faced before. The most common questions revolve around whether to expose a person to their diagnosis and the prognosis of their condition. Later, as the disease progresses, you may ask whether it is ever ok to deceive a person with dementia for “their own good.”

A piece in The New Yorker called “The Comforting Fictions of Dementia Care” is a must-read for anyone working with persons living with dementia. The article addresses some of today’s toughest ethical dilemmas facing dementia caregivers, both professional and family. Picture a person living with advanced stage dementia, who no longer remembers their spouse has passed away and routinely asks where he or she is. Do we risk reawakening the grief they felt at the time of their love one’s death, or do we fib a little and say that “Dad will be home after work,” which is in fact a lie?

I have never been a supporter of lying and I agree with many of the arguments in The New Yorker article against the use of deception to control or otherwise soothe the person living with dementia. There are many more suitable, and frankly more successful, ways to cope with such a scenario as I have described above. Validation is one such technique that can alleviate the ethical dilemma of the perceived need to lie or mislead a person with dementia who is upset. This technique should be well-known and practiced by all care partners. Developed by Naomi Feil, a social worker who began her work with people living with dementia decades ago, the technique involves using empathy and listening to help resolve the emotional need behind the behavior. For more information, visit Feil’s website for a list of her books and resources. At Brookdale, we understand that caring for someone with Alzheimer’s or another dementia, can place families in situations such as these and others that call for ethical choices to be made.

As part of our ongoing Optimum Life Continuing Education series, we’re offering the session Ethics in the Care of People with Dementia. This online session is led by Daniel Kuhn, LCSW, vice president of education at All Trust Home Care, and author of more than 50 publications, including The Art of Dementia Care. Khun is also an editorial board member of The American Journal of Alzheimer’s Disease. These pre-recorded webcasts provide 1.0 CE credit (one hour) per session for nurses, social workers, case managers and nursing home administrators.

“I hope participants gain a better understanding about ways to support people living with dementia and their family caregivers,” Kuhn said. “People with dementia are often caught between wishing to be independent while facing their growing limitations. An ethical framework can clarify their dilemmas and identify options for them and their families.”

Our Ethics in the Care of People with Dementia session covers things like who should decide if an when someone lacks the capacity to make decisions, how to balance self-determination with common good and several examples of ethical dilemmas. Those who watch the course will have an opportunity to evaluate some common ethical problems and identify alternative solutions.

Those who complete the session will learn to:

  • Define ethics and identify ethical principles
  • Explain ethical dilemmas in dementia care
  • Identify tools for making ethical decisions
  • Understand the use of ethical principles through case examples

For more information about the course Ethics in the Care of People with Dementia, click the link. Then scroll down to find a downloadable flyer. 

 

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